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Abstract #18421 Published in IGR 3-3
A prospective study on ocular hypertensive and antiinflammatory response to different dosages of fluorometholone in children
Fan DSP; Ng JSK; Lam DSCOphthalmology 2001; 108: 1973-1977
OBJECTIVE: To investigate the ocular hypertensive and anti-inflammatory response to different dosages of fluorometholone (FML). DESIGN: Prospective clinical trial with randomization of fellow eyes to different postoperative treatment. PARTICIPANTS: Thirty-one consecutive children undergoing bilateral symmetrical strabismus operation. INTERVENTION: Among 31 children who received bilateral squint operations, one eye was randomized to receive topical FML six times daily (group 1), while the other eye received topical FML three times daily (group 2), both for four weeks. Intraocular pressure (IOP) and anti-inflammatory responses were measured serially in the postoperative period for eight weeks. MAIN OUTCOME MEASURES: IOP was measured on the day before surgery and on postoperative days 1, 3, 6, 13, 20, 27, 41, and 55. The anti-inflammatory response was also assessed subjectively and objectively on days 6, 13, 30, and 27 after operation. Peak IOP, net increase in IOP, and anti-inflammatory responses in the two study groups were analyzed. RESULTS: Thirty-one children, aged three to nine years old (mean ± SD, 5.52 ± 1.81), participated in the study. IOP increased significantly in both groups compared to preoperative values (p < 0.001). Peak IOP ranged from 12.00-31.00 and 12.30-25.00 mmHg in groups 1 and 2, respectively. Mean peak IOP (19.00 ± 5.06 versus 17.13 ± 3.32 mmHg) was significantly higher in group 1 (p < 0.001). The net increase in IOP was similar (mean ± SD, 4.37 ± 4.79 versus 2.57 ± 3.32 mmHg; p = 0.005). The range of the net IOP increase was -1.00-16.00 and -2.50-10.30 mmHg in groups 1 and 2, respectively. Children in group 1 reached peak IOP earlier than those in group 2 (median, six versus 13 days; p = 0.033). However, there was no significant difference in anti-inflammatory response between the two groups. CONCLUSIONS: Ocular hypertension occurs in a dose-dependent manner in children treated with FML. Children in group 1 had a quicker onset and more severe ocular hypertensive response than those in group 2. It would be desirable to monitor IOP regularly when FML is being used at a high frequency and for a long duration in children.
Dr D.S.C. Lam, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, 147K Argyle Street, Kowloon, Hong Kong. dennislam@cuhk.edu.hk
Classification:
9.4.1 Steroid-induced glaucoma (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
